Brand Names: Canada

Warning

Estrogens may raise the chance of uterine cancer. Progestins may lower this chance. A warning sign for cancer of the uterus is vaginal bleeding. Report any vaginal bleeding to the doctor.

Do not use estrogens to prevent heart disease or dementia. Using estrogens may raise the chances of having a heart attack, a stroke, breast cancer, a blood clot, or dementia.

Use estrogens with or without progestin for the shortest time needed at the lowest useful dose.

What is this drug used for?

It is used to put off soft, brittle bones (osteoporosis) in women after change of life.

It is used to prevent or lower the signs of the change of life (menopause).

It is used when the ovaries have been taken out, are not working the right way, or have stopped working.

Rarely, it is used to treat breast or prostate cancers.

It may be given to you for other reasons. Talk with the doctor.

What do I need to tell my doctor BEFORE I take this drug?

If you have an allergy to estradiol or any other part of this drug.

If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.

If you have ever had a very bad or life-threatening reaction called angioedema. Signs may be swelling of the hands, face, lips, eyes, tongue, or throat; trouble breathing; trouble swallowing; unusual hoarseness.

If you have had any of these health problems: Bleeding disorder, blood clots, a higher risk of having a blood clot, breast cancer, liver disease, heart attack, stroke, or a tumor where estrogen makes it grow.

If you have unexplained vaginal bleeding.

If you are pregnant or may be pregnant. Do not take this drug if you are pregnant.

This is not a list of all drugs or health problems that interact with this drug.Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

Tell dentists, surgeons, and other doctors that you use this drug.

If you are allergic to tartrazine, talk with your doctor. Some products have tartrazine.

Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.

If you have high blood sugar (diabetes), talk with your doctor.

Have your blood pressure checked often. Talk with your doctor.

Have your blood work checked. Talk with your doctor.

Have a bone density test. Talk with your doctor.

Be sure to have regular breast exams and gynecology check-ups. Your doctor will tell you how often to have these. You will also need to do breast self-exams as your doctor has told you. Talk with your doctor.

This drug may cause dark patches of skin on your face. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.

This drug may affect certain lab tests. Be sure your doctor and lab workers know you take this drug.

Do not smoke. Smoking raises the chance of heart disease. Talk with your doctor.

Limit your drinking of alcohol.

If you drink grapefruit juice or eat grapefruit often, talk with your doctor.

Talk with your doctor if you will need to be still for long periods of time like long trips, bed rest after surgery, or illness. Not moving for long periods may raise your chance of blood clots.

This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.

If you are 65 or older, use this drug with care. You could have more side effects.

Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

Soft, brittle bones (osteoporosis):

This drug works best when used with calcium/vitamin D and weight-bearing workouts like walking or PT (physical therapy).

Follow the diet and workout plan that your doctor told you about.

Skin emulsion:

Do not use sunscreen on legs before using emulsion or soon after using emulsion.

Skin gel:

Do not use sunscreen before using gel or soon after using gel.

Do not use sunscreen on gel part for 7 days in a row.

Skin spray:

Check with your doctor about how to use sunscreen with this drug.

If a child touches the spray, she/he needs to wash the skin with soap and water.

Vaginal ring:

Tell your doctor if you have trouble getting the ring out.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

All products:

Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Change in strength on 1 side is greater than the other, trouble speaking or thinking, change in balance, or blurred eyesight.

Very upset stomach or throwing up.

Very bad belly pain.

Back pain.

Bulging eyes.

Change in how contact lenses feel in the eyes.

Change in eyesight.

A lump in the breast, breast soreness, or nipple discharge.

Breast pain.

Vaginal itching or discharge.

Vaginal bleeding that is not normal.

Low mood (depression).

Mood changes.

Memory problems or loss.

Fever.

Not able to pass urine or change in how much urine is passed.

Pain when passing urine.

Swelling.

Patch and skin emulsion:

Very bad skin irritation.

Vaginal ring:

Toxic shock syndrome (TSS) has happened in a few patients using vaginal rings. TSS is rare, but can be very bad and sometimes deadly. Tell your doctor right away if you have loose stools (diarrhea), dizziness or light-headedness, passing out, fever, muscle pain, upset stomach, throwing up, or a sunburn-like rash.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

Headache.

Hair loss.

Upset stomach or throwing up.

Cramps.

Bloating.

Enlarged breasts.

Breast soreness.

Vaginal bleeding or spotting.

Painful periods.

Patch and skin emulsion:

Skin irritation.

Shot:

Irritation where the shot is given.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read and follow the dosing on the label closely.

Shot:

It is given as a shot into a muscle.

Tablet:

Take this drug at the same time of day.

There may be days when you will not take this drug.

Take with or without food. Take with food if it causes an upset stomach.

All skin products:

Do not take this drug by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn).

Take this drug at the same time of day.

Do not use on skin that has any problems.

Do not put on the face, breast, or vagina.

Wash your hands before and after use.

Do not let any other person touch the gel, solution, or the treated part of your skin.

Skin emulsion:

Put on clean, dry, healthy skin.

Put contents of 1 pouch on 1 thigh. Rub into thigh and calf.

Put contents of the second pouch on the other thigh. Rub into thigh and calf.

Put any emulsion left on your hands on the buttocks.

Let dry before covering with clothing.

Skin gel:

Avoid fire, flames, or smoking until the gel has dried.

Let dry before covering with clothing.

Divigel®:

Put on clean, dry, healthy skin on the thigh.

Move the site with each packet.

Put over 5 x 7 inches.

Do not bathe, shower, or swim right after putting on.

EstroGel®:

Prime pump before first use.

Put on clean, dry, healthy skin of 1 arm from the wrist to the shoulder.

Do not bathe, shower, or swim right after putting on.

Elestrin®:

Prime pump before first use.

Put on clean, dry, healthy skin of upper arm and shoulder.

Do not bathe, shower, or swim for 2 hours after putting on.

Skin patch:

Put patch on clean, dry, healthy skin. Move the site with each new patch.

Put patch on a site without hair.

Do not place on breast. Place below waistline.

Do not put the patch on the waistline.

Do not use patches that are cut or do not look right.

If the patch falls off, put a new one on.

Wear only one patch at a time.

Skin spray:

Prime pump before first use.

Hold container upright and rest plastic cone flat on the skin while spraying.

Put on clean, dry, healthy skin of the inner forearm. Start near the elbow.

Let dry before covering with clothing.

Do not rub into skin.

Avoid fire, flames, or smoking until dry.

Vaginal ring:

Put into the vagina and leave in place for 90 days.

Follow how to use as you have been told by your doctor or read the package insert.

To use, wash your hands and take ring from the pouch.

Be sure your hands are dry before you touch this drug.

Press sides of ring at the same time between thumb and index finger and put folded ring into the vagina.

Perfect placement is not needed for the ring to work. The ring will not hurt.

To take out, hook your index finger around the rim or hold rim between index finger and middle finger and pull out.

Do not throw the vaginal ring in the toilet.

Wash hands after use.

What do I do if I miss a dose?

Shot and vaginal ring:

Call the doctor to find out what to do.

Skin patch:

Put on a missed patch as soon as you think about it after taking off the old one.

Skin gel and spray:

Use a missed dose as soon as you think about it.

If it is less than 12 hours until the next dose, skip the missed dose and go back to your normal time.

All other products:

Use a missed dose as soon as you think about it.

If it is close to the time for your next dose, skip the missed dose and go back to your normal time.

Do not use 2 doses or extra doses.

How do I store and/or throw out this drug?

Shot:

This drug will be given to you in a hospital or doctor’s office. You will not store it at home.

All other products:

Store at room temperature.

Store in a dry place. Do not store in a bathroom.

Pump:

Store at room temperature. Throw away any part not used after labeled number of doses are used.

Patch:

After you take off a skin patch, be sure to fold the sticky sides of the patch to each other.

All products:

Keep all drugs out of the reach of children and pets.

Check with your pharmacist about how to throw out unused drugs.

General drug facts

If your symptoms or health problems do not get better or if they become worse, call your doctor.

Do not share your drugs with others and do not take anyone else’s drugs.

Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.

Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.

Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, pharmacist, or other health care provider.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.